Brief history of dialysis in the world and in Argentina. Part 4: The beginnings of peritoneal dialysis in Argentina

Abstract

Based on previous experimental investigations about the anatomy and physiology of the peritoneum and the physicochemical phenomenon of osmosis realized in the 19th century in the world, peritoneal dialysis (PD) as treatment of uremia initiated in the 20th century in patients with acute kidney injury (AKI) or advanced chronic kidney disease (CKD), first in isolated attempts until 1975, when Moncrief et al. started continuous ambulatory PD. In Argentina, the first PDs were performed mainly in patients with AKI: in 1958 by Carlos Gianantonio et al, and in 1963 by Jorge Cucci, Shirley Rosello and Elsa Piulatsa, in both cases mainly in children with the hemolytic uremic syndrome. At the Institute of Medical Research (IDIM), also in 1963, López Blanco et al. performed PD in 19 adult patients with AKI or decompensated CKD and, in 1968, Lanari et al published their results in the treatment of AKI in 633 patients (44 with PD).The first chronic PD program began in September/1978 at the Central Polyclinic of the Unión Obrera Metalúrgica (Buenos Aires) in 8 patients, using national technology (peritoneal catheters and semi-rigid bags). Subsequently, the PD programs extended over the country: in 1980 at the Ricardo Gutierrez Children's Hospital (Buenos Aires) and at the Olivos Clinic (Buenos Aires Province); in 1981 at the IDIM (Buenos Aires city); in 1985 at the Private Hospital (Córdoba) and at the Sanatorio Parque (Rosario, Santa Fe); in 1986 at the Sanatorio Parque (Salta). Currently, according to the Argentine Dialysis Registry 2022, 2,497 individuals on 12/3/21 were receiving chronic PD (8.5% of the total under dialysis treatment).